Comparative Study of Clinical Outcomes of Severe and Critical COVID-19 Patients With and Without Hemoperfusion Admitted in a Referral Hospital

Abstract

<b>Introduction:</b> COVID-19&nbsp;has been a global problem since 2020, and is challenging to manage,leading to countless deaths worldwide. Severe cases are due to cytokine release syndrome resulted in acute respiratory distress syndrome. Hemoperfusion has been proposed as a means of removing cytokines from the circulation,theoretically improving survival. <b>Objectives:</b> This study compared the clinical outcomes of hemoperfusion among severe and critical COVID-19 patients admitted in a COVID-19 referral hospital. <b>Methods:</b> This is a retrospective cohort study involving hospital records of severe and critical COVID-19 adult patients. Patients were grouped according to severity and hemoperfusion status. Statistical analysis was done using Chi-square and Kaplan Meier survival analysis, through SPSS ver 22. <b>Results:</b> There were 435 patients included in the study, of which 155 were patients without hemoperfusion, and 280 with hemoperfusion. There was significant reduction in inflammatory markers (CRP, LDH, Ferritin &amp; D-dimer with p-value &lt;0.01) post-hemoperfusion for both severe critical&nbsp;groups. There was a higher survival probability of 45% and 20% on the 10th and 20th day of admission respectively among severe COVID-19 with hemoperfusion. Severe COVID-19 patient with hemoperfusion had higher extubation rate&nbsp;of&nbsp;34.4% than those without (9.5%).&nbsp;Among patients on Day 1-6 illness with hemoperfusion,they had higher survival probability of 80% than those who had it later. <b>Conclusion:</b> Hemoperfusion was associated with higher survival outcome among severe COVID-19 patients than those without. Apt timing of initiation of hemoperfusion can improve survival.